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By Ginger - Site Admin on Tuesday, October 03, 2017 8:20 AM

The status of the Disproportionate Share Hospital (DSH) surveys for respective State Fiscal Years (SFY) is now available. Several facilities are listed for the 2014 reviews and are requested to submit their information as soon as possible if they have not. 

Final settlements and resolution of appeals of prior SFYs are currently underway in abeyance pending the result of ongoing litigation at the federal level regarding payments from Third-party Payors.

By Ginger - Site Admin on Friday, August 04, 2017 8:22 AM
On Wednesday, the Centers for Medicare and Medicaid Services (CMS) released its Medicare inpatient hospital prospective payment system (IPPS) final rule for fiscal year 2018. This rule will significantly change the methodology for making Medicare disproportionate share hospital (DSH) payments. The new methodology will be phased in over three years. Preliminary estimates are that the new methodology will reduce Medicare DSH payments to Kentucky hospitals by about $77 million when the new method is fully in place in fiscal year (FY) 2020. KHA filed comments strongly objecting to these changes. Please note, this methodology only affects hospitals paid on a DRG basis, who also qualify for Medicare DSH.

Summary of Medicare DSH Changes

Hospitals that qualify for Medicare DSH payments will continue to receive 25 percent of the Medicare DSH funds under the pre-FY 2014 DSH formula, known as the empirically justified DSH payments. The remaining 75 percent of payments, which are paid from a...
By Ginger - Site Admin on Thursday, September 15, 2016 8:24 AM
On September 14, KHA submitted comments to the Centers for Medicare and Medicaid Services (CMS) on the proposed Medicaid disproportionate share hospital (DSH) rule addressing the treatment of third-party payers in calculating uncompensated care costs.

KHA and Kentucky's hospitals disagree with the position of CMS to require counting payments from Medicare and other private insurers to calculate uncompensated care costs for retention of DSH payments. The proposed rule would redefine a hospital's cost of care and is not authorized by statute.

The law states clearly that the only costs counted are Medicaid payments and payments made by uninsured patients, not payments made by other programs or insurers.

This proposal would harm many safety net hospitals, and would have devastating consequences for Kentucky's rural hospitals.

For a full copy of the comments, visit the Policy page in the Advocacy section of www.kyha.com.

If you have any questions,...
By Ginger - Site Admin on Monday, September 15, 2014 10:47 AM

The Department of Medicaid has confirmed that the ten percent holdback of the November 2013 Medicaid Disproportionate Share Hospital (DSH) payments were mailed September 22.

The final share factor used to distribute the balance of DSH funds for the November 2013 distribution is the same share factor that will be used by Medicaid when making the DSH payments for November 2014 and November 2015. Since the Federal funding has not changed for the next two years, and the share factor is constant, the Medicaid DSH payments for the next two years should be essentially the same as the payment for November 2013.

If you have any questions, please contact Steve Miller at KHA (502-426-6220 or 800-945-4542 or via email at smiller@kyha.com).


By Ginger - Site Admin on Tuesday, April 15, 2014 8:09 AM
On Monday, April 7, Myers and Stauffer, the contractor conducting the Medicaid Disproportionate Share Hospital (DSH) Audits for Kentucky Medicaid, distributed to hospitals by mail the fee for service (FFS) crossover and managed care organization (MCO) paid claims listing needed to complete the data submission required for the Medicaid DSH Surveys. The revised due date for the DSH survey is now April 25.

Hospitals are encouraged to submit the most complete and accurate data possible, keeping in mind the definition of uncompensated care. The 2011 audit year is the first year that hospitals may be subject to return a portion of their DSH payments if they are unable to document uncompensated care cost in excess of their Medicaid DSH payments received. In prior years since the findings were informational and hospitals were not subject to recoupments, many hospitals may not have filed all uncompensated care cost. Instead, they just filed enough cost to “cover” the amount of Medicaid DSH received.

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By Ginger - Site Admin on Friday, March 14, 2014 8:49 AM
Myers and Stauffer, under contract with Kentucky Medicaid, has begun the federal fiscal year (FFY) 2011 Medicaid Disproportionate Share Hospital (DSH) audits. Information was distributed to hospitals in early February with a due date of March 21. Hospitals have already received the Medicaid fee-for-services paid claims listing, with Medicare/Medicaid cross-overs and managed care claims to be distributed soon. An extension of the March 21 due date will probably be granted due to the late distribution of the additional paid claims listing.

Hospitals are encouraged to submit the most complete and accurate data possible, keeping in mind the definition of uncompensated care. The 2011 audit year is the first year that hospitals may be subject to return a portion of their DSH payments if they are unable to document uncompensated care cost reported on the survey. In prior years, since the findings were informational and hospitals not subject to recoupments, many hospitals may not have filed all uncompensated...
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